Is Nurtec Better Than Qulipta? A Head-to-Head Comparison for Migraine Management

October 7, 2025 •

4 min read

According to the Migraine Research Foundation, migraine is the third most prevalent illness in the world. For those living with this condition, two of the newest and most advanced oral treatments are Nurtec ODT and Qulipta. Understanding if Nurtec is better than Qulipta requires a close look at their distinct applications, from preventing monthly attacks to treating them as they occur.

Quick Summary

This article compares Nurtec ODT (rimegepant) and Qulipta (atogepant), two oral CGRP receptor antagonists for migraine management. Nurtec treats acute migraines and prevents episodic ones, while Qulipta is for preventing episodic and chronic migraines. Key differences include dosing frequency, formulation, side effects, and specific indications that determine which is more suitable for an individual's needs.

Key Points

Dual Function vs. Prevention Only: Nurtec ODT is approved for both acute treatment of migraines and preventive treatment of episodic migraines, whereas Qulipta is only approved for prevention (episodic and chronic).
Dosing Schedule and Formulation: Nurtec is an orally disintegrating tablet taken every other day for prevention, while Qulipta is a standard oral tablet taken daily.
Efficacy Nuances: For episodic migraine prevention, clinical trial data suggests Qulipta might be slightly more effective, though no head-to-head trials exist. Nurtec is the only one approved for treating an active migraine attack.
Side Effect Profile: While both commonly cause nausea, Qulipta has a higher reported incidence of constipation and fatigue, particularly at higher doses.
Individualized Choice: The better medication depends on your specific needs, such as whether you need acute relief, chronic prevention, or a combination, and which dosing schedule and side effect profile you tolerate best.
Not for Combination Use: Since both are CGRP antagonists, they should not be taken together, as this increases side effect risks without added benefit.

Both Nurtec ODT and Qulipta belong to a new class of oral migraine medications called CGRP (calcitonin gene-related peptide) receptor antagonists. The CGRP molecule plays a crucial role in triggering migraine attacks. By blocking the CGRP receptor, these drugs can prevent or stop a migraine from developing. While they share this common mechanism, their practical applications, dosages, and potential side effects differ, making the choice between them highly individual.

The Core Difference: Indications and Usage

The most significant distinction between Nurtec ODT (rimegepant) and Qulipta (atogepant) lies in their approved uses. This is the primary factor a healthcare provider will consider when recommending a treatment path.

Nurtec ODT (Rimegepant)

Nurtec ODT is a versatile medication with a dual function. It is FDA-approved for both:

Acute Treatment: Taking a single 75 mg orally disintegrating tablet (ODT) as needed can stop a migraine attack in progress, with or without aura. The tablet dissolves quickly on or under the tongue without water, providing rapid relief.
Preventive Treatment: Nurtec ODT can also prevent episodic migraines when taken every other day. It is not approved for chronic migraine prevention.

Qulipta (Atogepant)

Qulipta, by contrast, is solely a preventive medication. It is FDA-approved for preventing both:

Episodic Migraine: Taken as a daily oral tablet, Qulipta comes in several dosages (10 mg, 30 mg, and 60 mg).
Chronic Migraine: A 60 mg daily dose is approved for preventing chronic migraines, which occur 15 or more days per month.

This difference means that patients requiring relief for ongoing, active attacks in addition to prevention may benefit more from Nurtec, while those focusing strictly on long-term prevention, especially of chronic migraines, might find Qulipta more suitable.

Comparing Efficacy and Dosing Regimens

In terms of effectiveness for episodic migraine prevention, there have been no head-to-head clinical trials comparing Nurtec and Qulipta directly. However, data from separate studies suggests that Qulipta may offer a slightly greater reduction in monthly migraine days for episodic prevention. For example, one analysis noted a greater average reduction in monthly migraine days with Qulipta (60mg daily) compared to Nurtec (75mg every other day). That being said, treatment response is highly individualized, and what works better for one person may not work as well for another.

Regarding dosage, the schedules are another key differentiator. Nurtec's every-other-day regimen for prevention is convenient for some, while Qulipta's daily dose provides a consistent, once-a-day routine. The fact that Nurtec can also be used for acute attacks means a patient only needs one prescription for both purposes, a major convenience.

Side Effects and Patient Tolerability

Both medications are generally well-tolerated, and the most common side effect for both is nausea. However, there are some differences in the reported side effects based on clinical trial data:

Qulipta: Common side effects include nausea, constipation, fatigue or sleepiness, and decreased appetite. Constipation and fatigue were reported in a higher percentage of Qulipta users compared to placebo, particularly at higher doses.
Nurtec ODT: Common side effects for preventive use include nausea, stomach pain, and indigestion. For acute treatment, nausea is the most frequently reported side effect.

Serious allergic reactions are a rare but possible risk for both drugs. When comparing potential drug interactions, both are metabolized by the CYP3A4 enzyme in the liver, but Nurtec and Qulipta also interact with different transport proteins, which can affect metabolism and require dose adjustments with certain co-administered drugs.

Comparison Table: Nurtec ODT vs. Qulipta


Feature	Nurtec ODT (Rimegepant)	Qulipta (Atogepant)
Primary Indication	Acute and preventive treatment	Preventive treatment only
Specific Use	Acute relief (with or without aura); Prevention of episodic migraine	Prevention of episodic and chronic migraine
Dosing Schedule	Acute: As needed (max 18 doses/30 days); Prevention: Every other day	Daily, once per day
Formulation	Orally Disintegrating Tablet (ODT)	Standard Oral Tablet
Common Side Effects	Nausea, stomach pain, indigestion	Nausea, constipation, fatigue, decreased appetite
For Chronic Migraine	No	Yes
For Acute Attacks	Yes	No

Choosing the Right Medication: Factors to Consider

Ultimately, the choice between Nurtec and Qulipta is not about which is universally "better" but rather which aligns best with a person's specific migraine profile and lifestyle. Here are some key factors to discuss with a healthcare professional:

Treatment Goal: Do you need a medication for both acute attacks and prevention? Or is your primary goal solely prevention?
Migraine Type: Do you experience episodic (fewer than 15 days/month) or chronic (15+ days/month) migraines?
Formulation Preference: Some prefer the quick-dissolving convenience of Nurtec's ODT, while others may prefer a standard daily pill like Qulipta.
Side Effect Profile: Discuss any history of nausea, constipation, or other side effects to weigh the potential tolerability of each medication.
Dosing Routine: Consider whether a daily (Qulipta) or every-other-day (Nurtec) schedule fits your habits and is less likely to result in a missed dose.

Conclusion

Nurtec and Qulipta offer powerful new options for managing migraines by targeting the CGRP pathway. However, they are not interchangeable. Nurtec's dual ability to both prevent episodic migraines and treat acute attacks offers unique flexibility, while Qulipta's daily regimen is specifically designed for comprehensive prevention, including chronic migraines. The determination of whether is Nurtec better than Qulipta comes down to individual needs, with the guidance of a healthcare provider. It is not recommended to use both at the same time due to their similar mechanisms of action. By considering your specific needs, you and your doctor can choose the treatment that offers the greatest benefit with the fewest drawbacks.

Authority Outbound Link

Clinical Trials Arena: NURTEC (Rimegepant) for the Acute Treatment of Migraine

This article offers an in-depth look at the clinical studies, regulatory approvals, and specific findings related to Nurtec ODT's efficacy and safety.

Frequently Asked Questions

Yes, Nurtec ODT is uniquely approved for both acute treatment (taken as needed, max 18 doses in 30 days) and preventive treatment of episodic migraines (taken every other day).

No, Qulipta is not used for treating an active migraine attack. It is only indicated for the preventive treatment of migraines and is taken daily to reduce migraine frequency.

Both medications can cause nausea. However, Qulipta users have also reported higher rates of constipation and fatigue in clinical trials, especially at higher doses.

For episodic migraine prevention, some evidence from separate clinical trials suggests Qulipta might be slightly more effective at reducing monthly migraine days. However, there have been no head-to-head trials, and the best medication depends on individual response.

Nurtec ODT is an orally disintegrating tablet that dissolves on or under the tongue without water, which is convenient for rapid relief. Qulipta is a standard oral tablet that is swallowed with water.

Nurtec is approved for the prevention of episodic migraines, not chronic migraines. For chronic migraine prevention (15+ migraine days per month), Qulipta is an FDA-approved option.

Yes, it is possible to switch under a healthcare provider's supervision, particularly for episodic migraine prevention. However, the medications should not be taken concurrently, and the switch should be managed by a doctor.